Affordable Care Act Form 1095-B
Affordable Care Act Form 1095-B
Click Images to Enlarge

Quantity
Number of
Lot Price
50 $19.20 
100 $36.60 
200 $64.03 
300 $77.76 
500 $105.77 
1000 $181.25 
>1000 Call us at
1-800-982-3676
or Email Us For Price
Quantity:




Self-insured employers with less than 50 full-time employees, or insurers, must issue this form to employees/recipients and submit to the IRS as proof of healthcare coverage. Form 1094-B is the related transmittal.

Be sure to order enough to give to your employees and submit to the IRS.

There are no templates available for this product


Any tax forms ordered today will ship on Tuesday May 21, 2024 if Ground shipping is chosen
They will ship on Monday May 20, 2024 if Express shipping is chosen

Recently Viewed See More

Color Label 1UP 8 1/2" x 11" -1 vertical slit (#1020)

Starting at: $103.70

Integrated Labels used with ReadyShipper ® - LS-6X4BR v7.2.0

Starting at: $40.33

Lab Testing Forms with Specimen Labels (4UP)

Starting at: $40.33

Lab Testing Forms With Labels for Labcorp (8UP)

Starting at: $40.33

Lab Testing Specimen Labels (10UP)

Starting at: $40.00

Utility Bills - Standard White for Water Solutions Software

Starting at: $54.00